{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T09:19:38Z","timestamp":1762161578132,"version":"3.40.5"},"reference-count":21,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,11,2]],"date-time":"2020-11-02T00:00:00Z","timestamp":1604275200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The complications associated with <jats:italic>in vitro<\/jats:italic> fertilisation (IVF) for both the offspring and mother, and its high cost make it essential to tailor the technology to those infertile couples who truly benefit from it.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To determine whether a simple prognostic algorithm could discriminate between couples who require immediate fertility treatments and couples in whom less invasive strategies should be offered first.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>In this retrospective cohort study, couples were classified into six groups based on the medical necessity of IVF and their prognosis for natural conception: (i) tubal\/severe semen factor mandating immediate IVF due to the very low chance of natural conception; (ii) pure anovulation infertility; (iii) female age \u226539\u00a0years; and (iv) unexplained\/mild male infertility (no indication for immediate treatment) with (4A) good, (4B) moderate or (4C) poor prognosis of natural conception, as per an existing, validated prognostic model. For each group, we constructed Kaplan\u2010Meier curves to measure natural conception and the effect of fertility treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The 12\u00a0months cumulative live birth rate for couples with unexplained or mild male infertility and poor prognosis increased from 1% without treatment to 35% after treatment (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). In contrast, couples with good prognosis experienced a statistically insignificant increase in their cumulative live birth rate from 40% to 56% (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.07). This demonstrates that a prognostic model could predict a couple\u2019s chances of natural conception and the benefit they derive from treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This prognostic mode allows fertility treatment to be individually tailored to reduce unnecessary IVF without compromising fertility chances.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.13273","type":"journal-article","created":{"date-parts":[[2020,11,2]],"date-time":"2020-11-02T10:56:52Z","timestamp":1604314612000},"page":"297-303","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Can the use of diagnostic and prognostic categorisation tailor the need for assisted reproductive technology in infertile couples?"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1690-9150","authenticated-orcid":false,"given":"Zheng","family":"Song","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Nursing and Health Sciences Monash University Melbourne Victoria Australia"},{"name":"Department of Obstetrics &amp; Gynaecology Monash Health, Monash Medical Centre Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wentao","family":"Li","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Nursing and Health Sciences Monash University Melbourne Victoria Australia"},{"name":"Department of Obstetrics &amp; Gynaecology Monash Health, Monash Medical Centre Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sean","family":"O\u2019leary","sequence":"additional","affiliation":[{"name":"Discipline of Obstetrics &amp; Gynaecology School of Medicine and Robinson Research Institute The University of Adelaide Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bronwen","family":"Roberts","sequence":"additional","affiliation":[{"name":"Repromed Fertility Specialists Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helen","family":"Alvino","sequence":"additional","affiliation":[{"name":"Repromed Fertility Specialists Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5575-6049","authenticated-orcid":false,"given":"Kelton","family":"Tremellen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Gynaecology and Reproductive Medicine Flinders University Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3857-0856","authenticated-orcid":false,"given":"Moustafa A.","family":"Gadalla","sequence":"additional","affiliation":[{"name":"Discipline of Obstetrics &amp; Gynaecology School of Medicine and Robinson Research Institute The University of Adelaide Adelaide South Australia Australia"},{"name":"Department of Obstetrics and Gynaecology Women\u2019s Health Hospital Assiut University Assiut Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rui","family":"Wang","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Nursing and Health Sciences Monash University Melbourne Victoria Australia"},{"name":"Discipline of Obstetrics &amp; Gynaecology School of Medicine and Robinson Research Institute The University of Adelaide Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8337-550X","authenticated-orcid":false,"given":"Ben W.","family":"Mol","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Nursing and Health Sciences Monash University Melbourne Victoria Australia"},{"name":"Department of Obstetrics &amp; Gynaecology Monash Health, Monash Medical Centre Melbourne Victoria Australia"},{"name":"Discipline of Obstetrics &amp; Gynaecology School of Medicine and Robinson Research Institute The University of Adelaide Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,11,2]]},"reference":[{"doi-asserted-by":"publisher","key":"e_1_2_6_2_1","DOI":"10.1093\/oxfordjournals.humrep.a136366"},{"doi-asserted-by":"publisher","key":"e_1_2_6_3_1","DOI":"10.1016\/0140-6736(92)92425-F"},{"unstructured":"European Society of Human Reproduction and Embryology.The world\u2019s number of IVF and ICSI babies has now reached a calculated total of 5 million. Press release 2 July 2012.www.eshre.eu\/eshre\/english\/press\u2010room\/press\u2010releases\/press\u2010releases\u20102012\/5\u2010million\u2010babies\/page.aspx\/1606","key":"e_1_2_6_4_1"},{"volume-title":"Assisted Reproductive Technology in Australia and New Zealand 2016 (ISBN\u201013: 978\u20100\u20107334\u20103827\u20101)","year":"2018","author":"National Perinatal Epidemiology and Statistics Unit","key":"e_1_2_6_5_1"},{"doi-asserted-by":"publisher","key":"e_1_2_6_6_1","DOI":"10.1136\/bmj.a716"},{"doi-asserted-by":"publisher","key":"e_1_2_6_7_1","DOI":"10.1093\/humrep\/deh744"},{"doi-asserted-by":"publisher","key":"e_1_2_6_8_1","DOI":"10.1016\/j.fertnstert.2009.12.027"},{"doi-asserted-by":"publisher","key":"e_1_2_6_9_1","DOI":"10.1097\/AOG.0b013e31825b88fc"},{"doi-asserted-by":"publisher","key":"e_1_2_6_10_1","DOI":"10.1161\/CIRCULATIONAHA.111.071183"},{"doi-asserted-by":"publisher","key":"e_1_2_6_11_1","DOI":"10.1093\/humupd\/dms062"},{"doi-asserted-by":"publisher","key":"e_1_2_6_12_1","DOI":"10.1093\/humupd\/dms044"},{"doi-asserted-by":"publisher","key":"e_1_2_6_13_1","DOI":"10.1016\/j.fertnstert.2007.09.005"},{"doi-asserted-by":"publisher","key":"e_1_2_6_14_1","DOI":"10.5694\/mja16.01435"},{"doi-asserted-by":"publisher","key":"e_1_2_6_15_1","DOI":"10.1093\/humrep\/deh365"},{"doi-asserted-by":"publisher","key":"e_1_2_6_16_1","DOI":"10.1093\/humrep\/del378"},{"doi-asserted-by":"publisher","key":"e_1_2_6_17_1","DOI":"10.1093\/humrep\/dep341"},{"doi-asserted-by":"publisher","key":"e_1_2_6_18_1","DOI":"10.1016\/S0140-6736(99)04002-7"},{"doi-asserted-by":"publisher","key":"e_1_2_6_19_1","DOI":"10.1136\/bmj.g7771"},{"doi-asserted-by":"publisher","key":"e_1_2_6_20_1","DOI":"10.1093\/humrep\/der279"},{"unstructured":"Fertility Europe. (2017 March).A policy audit on fertility analysis of 9 EU Countries[Press release]. Retrieved fromhttp:\/\/www.fertilityeurope.eu\/wp\u2010content\/uploads\/2018\/03\/EPAF_FINAL.pdf","key":"e_1_2_6_21_1"},{"doi-asserted-by":"publisher","key":"e_1_2_6_22_1","DOI":"10.1136\/bmjopen-2018-025845"}],"container-title":["Australian and New Zealand Journal of Obstetrics and Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajo.13273","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ajo.13273","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajo.13273","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,28]],"date-time":"2023-09-28T12:42:50Z","timestamp":1695904970000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/ajo.13273"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,2]]},"references-count":21,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021,4]]}},"alternative-id":["10.1111\/ajo.13273"],"URL":"https:\/\/doi.org\/10.1111\/ajo.13273","archive":["Portico"],"relation":{},"ISSN":["0004-8666","1479-828X"],"issn-type":[{"type":"print","value":"0004-8666"},{"type":"electronic","value":"1479-828X"}],"subject":[],"published":{"date-parts":[[2020,11,2]]},"assertion":[{"value":"2020-06-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-09-22","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-11-02","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}